Evidence-based clinical practice guidelines for irritable bowel syndrome 2020.
5-HT3 antagonists
5-HT4 agonists
Antibiotics
Antidepressant
Brain-gut interactions
Complications
Diagnosis
Epidemiology
Functional bowel disorder (FBD)
Functional gastrointestinal disorders (FGIDs)
Infection
Inflammation
Intestinal secretagogues (gut epithelial modifier)
Irritable bowel syndrome (IBS)
Microbiota
Mucosal permeability
Pathophysiology
Probiotics
Prognosis
Psychosocial stress
Psychotherapy
Rome IV criteria
Treatment
Journal
Journal of gastroenterology
ISSN: 1435-5922
Titre abrégé: J Gastroenterol
Pays: Japan
ID NLM: 9430794
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
16
08
2020
accepted:
27
10
2020
pubmed:
5
2
2021
medline:
15
12
2021
entrez:
4
2
2021
Statut:
ppublish
Résumé
Managing irritable bowel syndrome (IBS) has attracted international attention because single-agent therapy rarely relieves bothersome symptoms for all patients. The Japanese Society of Gastroenterology (JSGE) published the first edition of evidence-based clinical practice guidelines for IBS in 2015. Much more evidence has accumulated since then, and new pharmacological agents and non-pharmacological methods have been developed. Here, we report the second edition of the JSGE-IBS guidelines comprising 41 questions including 12 background questions on epidemiology, pathophysiology, and diagnostic criteria, 26 clinical questions on diagnosis and treatment, and 3 questions on future research. For each question, statements with or without recommendations and/or evidence level are given and updated diagnostic and therapeutic algorithms are provided based on new evidence. Algorithms for diagnosis are requisite for patients with chronic abdominal pain or associated symptoms and/or abnormal bowel movement. Colonoscopy is indicated for patients with one or more alarm symptoms/signs, risk factors, and/or abnormal routine examination results. The diagnosis is based on the Rome IV criteria. Step 1 therapy consists of diet therapy, behavioral modification, and gut-targeted pharmacotherapy for 4 weeks. For non-responders, management proceeds to step 2 therapy, which includes a combination of different mechanistic gut-targeted agents and/or psychopharmacological agents and basic psychotherapy for 4 weeks. Step 3 therapy is for non-responders to step 2 and comprises a combination of gut-targeted pharmacotherapy, psychopharmacological treatments, and/or specific psychotherapy. These updated JSGE-IBS guidelines present best practice strategies for IBS patients in Japan and we believe these core strategies can be useful for IBS diagnosis and treatment globally.
Identifiants
pubmed: 33538894
doi: 10.1007/s00535-020-01746-z
pii: 10.1007/s00535-020-01746-z
pmc: PMC7932982
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
193-217Commentaires et corrections
Type : ErratumIn
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